DailyDirt: Take Your Vitamins... Or Not. Who Knows What's Good For You?

from the urls-we-dig-up dept

It's not always simple to know what's good for your health. We've seen that the placebo effect is far more complicated than it seems (or is usually presented) as its effects have grown stronger and stronger over the years across many clinical trials. Doctors themselves aren't always certain what's the "best" health advice, and they're constantly re-evaluating whether current recommendations are actually valid -- to develop better recommendations. Here are just a few links on vitamins and some of their (mistaken) benefits.

• Vitamin deficiencies are certainly something to avoid, but some folks are going a bit too far with their vitamins. There is little evidence that antioxidant supplements prevent any kind of disease, but advertisers encourage everyone to take vitamin A and other dietary supplements in vast excess. More is not necessarily better, especially when it comes to vitamins. [url]
• Studies come out all the time that correlate the intake of vitamins with various health benefits, but that's not supposed to lead us to taking more vitamins. You're probably not going to suffer from rickets any time soon, so lay off the vitamin D and just go outside occasionally. [url]
• The amount of iron in spinach was mistakenly thought to be much higher than other green vegetables, but spinach actually doesn't have an extraordinary amount of iron. People also thought that Popeye ate spinach for the iron, but Popeye actually ate spinach for its vitamin A content.... [url]

If you'd like to read more awesome and interesting stuff, check out this unrelated (but not entirely random!) Techdirt post via StumbleUpon.

Filed Under: antioxidants, dietary supplements, health, iron, placebo effect, popeye, spinach, vitamins

DailyDirt: Slowly Piecing Together How The Brain Works

from the urls-we-dig-up dept

Scientists are learning more and more about the human brain all the time. We've learned a lot about the brain by studying disorders and instances of the brain not working the way it normally does. But there are also new medical imaging devices that allow researchers to take a peek at how normal brains work, too. Here are just a few links about some fascinating brain studies.

• Scientists at UC Berkeley have started to develop a method that could reconstruct mental images using functional magnetic resonance imaging (fMRI) to measure the brain activity of volunteers. Reconstructed videos aren't exactly high definition reproductions, but they vaguely match up to the videos that the volunteers are shown. [url]
• The placebo effect (for pain) has been shown to involve cannabinoid receptors in the brain. The study suggests that people are capable of creating their own natural opiate-like chemicals with some training. [url]
• After a professor of neuroscience developed synesthesia and started to actually feel sounds, there's a bit more interest in discovering how the sense of touch is related to hearing. Come on, feel the noise. Girls, rock your boys. [url]
• To discover more interesting articles on the human mind, check out what's currently floating around the StumbleUpon universe. [url]  

By the way, StumbleUpon can recommend some good Techdirt articles, too.

Filed Under: brain, fmri, placebo effect, senses, synesthesia

Study Suggests Placebos Don't Have To Be Secret To Work

from the this-is-important dept

I travel an awful lot, and for a while I used to come down with a cold fairly frequently after traveling (one of the usual hazards of air travel). Somewhere along the way -- a few years back -- someone suggested that I try Airborne, the tablets you drop into some water that fizz up and put a bunch of random vitamins and whatnot into your system. From the beginning, I was pretty skeptical about it (I don't tend to believe in such things), but figured I didn't have much to lose, and started taking Airborne when I travel. Since then, I can't recall ever ending up sick during or after traveling. There have been a few times when I felt like I was coming down with something, but then I'd take an Airborne and feel fine again by the next day. It was weird.

Still, I wasn't all that surprised, two years ago, when a report came out blasting Airborne, with the FTC fining the company, saying that there was "no credible evidence" that it worked. I thought about stopping my routine, but after thinking about it, I kept doing it (and was happy to see that Airborne actually became much cheaper after this). And it still worked for me -- even though I was now more convinced than ever that it's merely a placebo. But since then I have been really curious about this idea, as to whether or not someone could take something, even believing that it was a placebo, and have it still work. I even would joke about it with people, that even though I knew it didn't work, I was going to keep taking it until I had proof it didn't work.

Since then, I've become more and more interested in the concept of the placebo effect -- not really even believing my own story (sample size of one, plus confirmation bias, makes me distrust my own evidence...). Last year, we wrote about how the pharma industry was downplaying the placebo effect, even though there was growing evidence that people taking placebos were actually getting better, and it was leading more and more drugs to fail to pass clinical trials, since they didn't outperform placebos. The general reaction to this was to assume the drugs didn't work (which could be true), but very little effort was put into figuring out how come some people taking the placebos did seem to get better. There has been some research done in this area, but a major problem is that pharmaceutical companies have been refusing to share the data from their various clinical trials that would provide much needed data about the placebo effect.

The latest bit of research on this issue (which Mike mentioned in his recent DailyDirt post), is that some researchers have done a study which at least suggests that (as I found with Airborne) even when patients know that they're taking a placebo, it can still have an actual beneficial impact on their health. Now, this is just one study, and it's rather limited, but it's an intriguing area of research that I hope will get a lot more exploration as well. Mike wrote it off to bad control experiments, but I'm wondering if there's something more here.

Again, what would be really helpful is if pharmaceutical companies would release the data they already have from various clinical trials, which would allow for a much deeper analysis of the placebo effect. But, of course, they don't see much benefit in doing that. They want monopolies on drugs -- and evidence of a working placebo effect could harm their business prospects, even if it did lead to a better understanding of how to actually make people healthy. I have no doubt that certain drugs really do make people healthier. But if we could figure out how people are made healthier in the absence of drugs -- even when they know they're getting a placebo, we might get closer to really understanding certain elements of health that could actually serve to make future drugs a lot more effective in keeping people healthy (and, potentially also get past thinking of healthcare as being drugcare, when there's a lot more to keeping people healthy than just pharmaceuticals).

Over four years ago, Andy Kessler came out with his book, called The End of Medicine, which highlights how unfortunate it is that our healthcare system is really dominated by the pharmaceutical industry, where the focus is on "what drugs can be sold," rather than "what can actually make people healthy." In Kessler's book, what suffers are unique technologies that make people healthy, but have trouble getting approval for use (or money for research) because they don't fit into the usual drug classification systems. But it seems that the same sort of thinking applies to the lack of serious effort behind understanding the placebo effect. Hopefully, that's starting to change...

Filed Under: drugs, health care, placebo effect, placebos

The Placebo Effect: Things Pharma Prefers You Not Worry About

from the here,-take-this-sugar-pill dept

There's a fascinating article in the latest issue of Wired about the placebo effect and pharmaceutical companies. It's fascinating for a few reasons: First, because it shows the thought process of pharma firms and why "what's best for pharma" is often not what's best for your health (which is a line often trotted out by those who believe in protecting pharma). Second, because it suggests that some (potentially significant) parts of pharmaceutical science -- the stuff we hear over and over again is so important to protect via patents -- is bunk. And, finally, just because it may surprise you to know just how powerful the placebo effect appears to be -- and that it's only getting stronger.

The critical point is that final one. Basically, the placebo effect (the impact had on a patient taking a sugar pill under the false impression that it's medicine) seems to be quite real and, at times, quite powerful and lasting. Even more surprising is that, over time, the placebo effect has only become stronger and stronger.

Now, if pharmaceutical companies were actually interested in your health, then this would be a ripe area of study, well worth exploring to see if the placebo effect could be better understood and somehow harnessed to make people healthy. But, of course, you can't patent a sugar pill, so pharma research dollars have gone into drugs that can be patented.

However, a serious problem has arisen: with the placebo effect getting stronger and stronger, these "wonder drugs" that pharma has been spending millions of dollars "developing" have increasingly been failing clinical trials, because they can't out-perform placebos. The theory behind testing against placebos is that if a drug doesn't outperform the placebo, you have to question what good the actual drug is and why it should be approved. So, if a drug fails to outperform a placebo, then (the thinking goes) the drug is useless. But that's partly based on the idea that the effect of taking a placebo is weak.

This leaves out an important part of the equation: If the placebo is really effective in dealing with certain issues, then why not examine how to utilize that fact to make people healthy? Some in the pharma world have been pushing for this for a long time, and have repeatedly asked the big pharma companies to release their data on clinical trials, in order to better understand the impact of placebos and to see if there's a way to harness their power. But the pharma companies have resisted and don't want to release the data -- in part because they're scared to death of what this all means. If sugar pills are effective, that's a very different business, and the claims of all of the drugs that are on the market would be called into serious question. Instead, they've apparently spent their time writing out detailed marketing plans that convince doctors to prescribe medicine that doesn't work any better than alternatives.

Now, let's be quite clear here: I am not saying that drugs don't do any good. There are plenty of pharmaceuticals that certainly help deal with certain conditions, and there are plenty of people who lead better lives (or are alive at all) solely because of modern medicine. But, these findings about the placebo effect certainly suggest that -- at least in many cases -- rather than dumping chemicals into the human system via a pill, your brain may actually be a lot more effective at concocting the proper chemicals itself.

If we had a healthcare system built on incentives to actually keep people healthy -- rather than just to sell more pills -- this would be the beginning of a very important field of study. Instead, it's been resisted and the data has been hidden away for years.

The incentive system is clearly screwed up. It's based on patents and hoarding information, rather than on actually keeping people as healthy as possible. If you could craft a healthcare system that actually rewards those who keep patients healthy, then perhaps we'd actually know a lot more about the placebo effect and, beyond it, our own brains' ability to produce important, potentially life-saving or life-improving chemicals on its own. In fact, in such a system, the incentives would be less about hoarding information, and more about sharing it, since, through collaboration, it would be more likely that more people could be kept healthier, allowing greater overall profits. The problem today is that the system is based on incentives that are misaligned... and thus, it's a struggle to get anyone to care about the fact that the placebo effect actually seems to help some people.

Update: As pointed out in the comments, Skeptic Magazine recently had an article that provides some more thoughts on placebos.

Filed Under: economics, healthcare, incentives, patents, pharma, placebo effect